Isolated perifacial lymph node metastasis in oral squamous cell carcinoma with clinically node-negative neck

Area of Science:

• Oncology
• Head and Neck Surgery
• Pathology

Background:

• The prevalence of occult perifacial lymph node metastasis in oral cavity squamous cell carcinoma (OCSCC) with a clinically node-negative neck is not well-established.
• Understanding this incidence is crucial for refining neck dissection strategies.

Purpose of the Study:

• To determine the incidence of isolated perifacial lymph node metastasis in OCSCC patients presenting with a clinically node-negative neck.
• To provide data that can inform decisions regarding routine comprehensive removal of perifacial lymph nodes during selective neck dissection.

Main Methods:

• Prospective analysis of 231 patients with OCSCC and a clinically node-negative neck.
• Intraoperative separation of lymph node levels from the main surgical specimen for detailed pathological evaluation.

Main Results:

• 19 out of 231 patients (8.22%) exhibited isolated ipsilateral perifacial lymph node metastasis.
• No significant difference in incidence was observed between oral tongue (7.14%) and buccal mucosa (7.75%) cancers.
• Higher incidence was noted in younger patients (<45 years), advanced T stage, and deeper tumor invasion.

Conclusions:

• Isolated perifacial lymph node metastasis occurs at a significant rate in OCSCC patients with clinically node-negative necks.
• The incidence is notable in both buccal mucosal and tongue cancers.
• Careful dissection of perifacial lymph nodes is advisable in the management of OCSCC patients undergoing neck treatment.